A combination of the unthinkable and the incredible, the deaths have turned two first-time fathers into widowers, shaken the tiny school and its close-knit borough of Barrington, and left myriad questions about what went wrong.

"It's just unbelievable," said Barrington Mayor John Rink, whose son Nolan was in Scythes' class last year.

Scythes, 35, died March 28. The cause is unclear, and final autopsy results are pending, said John Baldante, a Philadelphia lawyer representing the family.

Farah, 28, died April 12 of "shock, due to bleeding and anemia," according to her death certificate. The family's attorney, Todd Miller of Allentown, said he was awaiting an autopsy report.

Underwood Hospital spokesman Richard Bellamente said the women were "treated and transferred" to Hahnemann University Hospital and Cooper University Hospital - although he did not know which woman went where.

According to people who knew the women, Scythes was airlifted to Hahnemann University Hospital, while Farah was rushed to Cooper University Medical Center in Camden.

The New Jersey Department of Health and Senior Services, which investigates deadly medical errors, has not received reports or complaints regarding the care of the two women, department spokesman Nathan Rudy said.

Death during or around the time of childbirth, a common occurrence a century ago, is now extraordinarily rare in this country. In 2000, 396 women in this country died of obstetric complications of pregnancy or treatment of those complications - including incorrect treatment, federal statistics show. That's fewer than eight women per 100,000 births.

"It's like winning the lottery - a bad one," said Louis Weinstein, chair of obstetrics at Jefferson University Hospital.

The most common causes of such deaths are blood clots, a blood-pressure disorder called eclampsia, and a coagulation disorder triggered by, among other things, hemorrhage, said Robert Debbs, a high-risk obstetrician at Pennsylvania Hospital who also practices at Underwood and is familiar with the cases.

In Debbs' opinion, "the Underwood cases were both catastrophic complications that could have occurred anywhere in the country and were unpreventable," he wrote in an e-mail.

By all accounts, the poignancy of death so closely linked to birth has been compounded by the coincidence that Scythes and Farah were friends and colleagues in a small suburb. They were known to just about everyone with children in the two elementary schools that serve the 1.2-square-mile Camden County borough of 7,000.

Although Scythes came to the district four years before Farah, both were alumnae of Rowan University and loved working with special-education students.

Avon principal Anthony Arcodia, a 25-year veteran of the district, said he interviewed both and recommended they be hired. "They had a level of passion and enthusiasm. The last day I saw them, they still had it."

Scythes was known for giving her pupils individual, handmade Christmas ornaments. Both women were known for their love of all things Disney.

Daniel Farah, 29, a computer-information specialist who met his wife-to-be at Collingswood High School, recalled: "I proposed to her in front of the castle in Disney World after dinner at Cinderella's Castle. They had cleared everyone from in front of the castle for the fireworks show, and we were the only ones there."

The couple married in July 2005 and built a house in nearby Oaklyn.

"We started trying to have a baby on our first anniversary," he said. "I was a planner. She was a planner."

James Scythes, a college history professor who lived with his wife in Woodbury, declined to be interviewed. Baldante said his client wanted time to deal with the emotional trauma and questions surrounding his wife's death.

Underwood Hospital has about 1,100 deliveries a year, hospital billing records show. It is one of two hospitals with maternity units in Gloucester County.

Underwood has "never" had a maternal death, Bellamente said. He declined to discuss the cases, citing privacy rules. "Hospital policy and practice is to refrain from disclosing protected health information."

An Inquirer analysis of Underwood billing records shows that between 2001 and 2005, seven obstetric patients were transferred to other medical facilities.

In the Barrington school district, news of Scythes' death was shared by a letter sent home to parents. At the Avon school, which serves children in kindergarten through fifth grade, Melissa Farah was beyond grief-stricken.

"She said: 'Oh my God. Is this going to happen to me?,' " recalled parent-teacher association president Beth Cavallaro. "We tried to reassure her and said: 'No, no. It was just a freak thing.' "

On the Sunday night after Farah's death, the district's automated recording service called each Avon parent to alert them that an unspecified "tragedy" had occurred and that counselors would be available at the school to talk to the children.

Proposals for memorials to the teachers - and funds for their babies - are coming from all quarters, Arcodia said.

Already, the parent-teacher association has ordered plaques that will be unveiled at back-to-school night in September, Cavallaro said. The organization also plans to install a tree, a bench, and specially inscribed bricks in the new playground, to be built in August with $52,000 raised from Barrington parents and businesses.

Still, for most of those who knew the women, the double tragedy remains incomprehensible.

"Even if it was an act of God," said Daniel Farah, "the odds of two new mothers dying, then that those two people did the same thing for a living, that they worked together, that they went to one another's baby showers - the odds are astronomical."

For photos, obituaries and tributes to Valerie Scythes and Melissa Farah, go to http://go.philly.com/health

To Contribute

Funds have been set up for both of the babies.

For Melissa Farah's daughter:

Checks should be made to "Grace Melissa Farah UGMA Fund"

Pinnacle Food Group Inc.

6 Executive Campus

Suite 100

Cherry Hill, N.J. 08002

For Valerie Scythes' daughter:

Checks should be made to "Isabella Rose Scythes Trust Fund"

409 Mantua Ave.

Woodbury, N.J. 08096

Staff writers Josh Goldstein and John Sullivan contributed to this report.

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